Dewitt Charles Fortenberry, MD | |
2602 Saint Michael Dr, Suite 302, Texarkana, TX 75503-2387 | |
(903) 336-2391 | |
Not Available |
Full Name | Dewitt Charles Fortenberry |
---|---|
Gender | Male |
Speciality | Internal Medicine |
Experience | 34 Years |
Location | 2602 Saint Michael Dr, Texarkana, Texas |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1114960473 | NPI | - | NPPES |
167594401 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | L8691 (Texas) | Secondary |
208D00000X | General Practice | L8691 (Texas) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Christus Homecare - St Michael | Texarkana, TX | Home health agency |
Christus St Michael Health System | Texarkana, TX | Hospital |
Wadley Regional Medical Center | Texarkana, TX | Hospital |
Uams Medical Center | Little rock, AR | Hospital |
The Villa At Texarkana | Texarkana, TX | Nursing home |
Entity Name | Medeval, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1740548346 PECOS PAC ID: 9537319256 Enrollment ID: O20121015000495 |
Mailing Address | Practice Location Address |
---|---|
Dewitt Charles Fortenberry, MD 116 Westlake Rd, Texarkana, TX 75501-0006 Ph: (903) 293-7093 | Dewitt Charles Fortenberry, MD 2602 Saint Michael Dr, Suite 302, Texarkana, TX 75503-2387 Ph: (903) 336-2391 |
Ronald David Rush, MD General Practice Medicare: Not Enrolled in Medicare Practice Location: 5503 N Stateline Ave, Texarkana, TX 75503 Phone: 903-794-7874 Fax: 903-794-0740 |